Should I use this page, or skip it?
Use this page if you have noticed a pounding, racing or fluttering heartbeat and need to know whether to see a GP or call 999. Skip it and call 999 if palpitations come with chest pain, severe breathlessness, collapse, or they are new and you feel very unwell. This page cannot diagnose a rhythm or read a smartwatch.
A first episode is not “only anxiety” until a clinician has thought about the heart. See chest pain if pain is the main symptom.
What are palpitations and what do they feel like?
Palpitations are when you become aware of your heartbeat. It may feel fast, hard, fluttering, or as if it skips or extra-beats. Some people feel it in the throat or neck. Episodes may last seconds or minutes and often show up in a quiet room at night.
Almost everyone notices this sometimes. The useful questions are whether you feel otherwise well, whether the pulse is regular, and whether red-flag symptoms are present.
What commonly sets them off?
Caffeine, energy drinks, alcohol, nicotine, dehydration, fever, hard exercise, and lack of sleep are frequent triggers. Some cold remedies and inhalers can contribute. Hormonal change in pregnancy or menopause, anaemia, and thyroid problems are medical causes a GP can test for.
Anxiety and panic attacks release adrenaline and can race the heart. That is real physiology. It still does not let you skip assessment the first time you have chest pain or feel close to collapse.
When might it be a heart rhythm problem?
Atrial fibrillation is an irregular, often fast rhythm that becomes more common with age and raises stroke risk. Sudden very fast regular episodes that start and stop abruptly can be other arrhythmias. An irregular pulse is a GP job even if you feel fairly well.
A GP can arrange an ECG, blood tests, and sometimes a wearable monitor. Do not wait for a perfect episode during the appointment. Bring a note of timing, triggers, and any watch alerts. A watch tracing is a prompt to get an ECG, not a diagnosis you should treat yourself.
What can I do if I feel well between episodes?
Cut back caffeine and alcohol, sleep more, and stay hydrated. Note what you were doing when it happened. Take a list of medicines, including inhalers and cold remedies, to the GP. Do not start blood-thinning tablets because a watch said “AF”.
If a clinician has shown you a safe vagal manoeuvre, use it only without red flags. If you feel faint, sit or lie down. Do not drive during an episode. If a clinician has shown you a safe vagal manoeuvre, use it only without red-flag symptoms.
When is it 111 or 999?
Call 999 for palpitations with chest pain, severe breathlessness, collapse or fainting, or a new episode where you feel very unwell. Treat that as a possible heart attack or dangerous rhythm until you are told otherwise — not as anxiety first.
Use 111 in England, Scotland and Wales if you are unsure and not in immediate danger. Northern Ireland uses GP out-of-hours via nidirect. Book a GP for frequent, longer, or irregular episodes once the emergency question is answered.
Do NHS doors differ across the UK?
Call 111 in England, Scotland and Wales if you need urgent advice and are not in immediate danger; Northern Ireland uses GP out-of-hours via nidirect rather than a general 111 service. Pharmacy schemes and what is free also vary by nation and local area, so ask rather than assuming last year’s rule still applies.
999 is the same emergency number everywhere. A sexual health clinic, GP or pharmacist in any UK nation can still start the right pathway even if the branding of the minor-illness scheme is different. Take a list of medicines and allergies with you.
Who should skip this page?
Skip this page if you already have chest pain, severe breathlessness or have collapsed — call 999. It is not an ECG report, not a watch-diagnosis service, and not permission to ignore an irregular pulse because you are young and stressed. Known heart disease plus new palpitations belongs with a GP or 111 the same day.
Common questions about palpitations
- What do palpitations feel like?
- An awareness of your own heartbeat. It may pound, race, flutter, or seem to skip. You might feel it in the chest, throat or neck. Episodes can last seconds or minutes. Many people notice them in bed when the room is quiet. The description helps a GP, so note what you felt and how long it lasted.
- Are palpitations dangerous?
- Often they are not, especially with a clear trigger such as caffeine when you otherwise feel well. They can still be a heart-rhythm problem that needs treatment, including atrial fibrillation, which raises stroke risk. A first episode with chest pain, severe breathlessness or collapse is 999. Do not decide it is anxiety on your own the first time.
- What commonly triggers them?
- Stress, caffeine, energy drinks, alcohol, nicotine, dehydration, lack of sleep, fever, pregnancy, menopause, and some cold remedies or asthma inhalers. An overactive thyroid or anaemia can also drive a racing heart. Cutting a trigger helps only after serious causes have been considered. Keep a list of medicines to show the GP.
- What is atrial fibrillation?
- An irregular, often fast heartbeat that becomes more common with age. It increases the chance of stroke and usually needs assessment for blood-thinning and rate control. If your pulse feels irregular, see a GP even if you feel otherwise well. A watch alert is a prompt to get an ECG, not a diagnosis on its own.
- What tests might I have?
- A GP will usually check your pulse and blood pressure and arrange an ECG. Blood tests often include thyroid function and a check for anaemia. If episodes are intermittent you may wear a monitor for a day or longer. Attend even if you feel fine when the appointment comes — the tracing still helps.
- Can anxiety cause palpitations?
- Yes. Adrenaline from anxiety or a panic attack can make the heart race. That does not make a first severe episode 'only anxiety'. Call 999 if there is chest pain, severe breathlessness, collapse, or you feel very unwell. Once a clinician has ruled out an urgent heart problem, treating anxiety often reduces palpitations.
- Should I try vagal manoeuvres?
- Only if a clinician has shown you a safe method and you do not have red-flag symptoms. Bearing down or splashing cold water on the face can sometimes slow a fast rhythm. Do not do this while driving, if you have chest pain, or if you feel faint. If in doubt, sit down and call 999 or 111.